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Combined alcohol septal ablation and transcatheter aortic valve replacement: Drunk and playing with fire
Author(s) -
Rowin Ethan J.,
Kimmelstiel Carey
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28795
Subject(s) - alcohol septal ablation , medicine , stenosis , cardiology , ventricular outflow tract , valve replacement , aortic valve replacement , aortic valve , aortic valve stenosis , ablation , hemodynamics , ventricular outflow tract obstruction , surgery , mitral valve , hypertrophic cardiomyopathy , obstructive cardiomyopathy
Key Points Evaluation of the severity of aortic stenosis in the presence of dynamic left ventricular outflow (LVOT) obstruction is challenging. Invasive hemodynamic assessment with provocative maneuvers can be useful to differentiate of the relative components of obstruction. In patients with both dynamic LVOT obstruction and aortic stenosis, surgical myectomy and concurrent surgical aortic valve replacement is the optimal treatment strategy; combined alcohol septal ablation and transcatheter aortic valve replacement should only be considered for very high surgical risk patients.